Advanced Search

Home Health & Hospice Week

Audits:

Medicaid RACs Slated To Fire Up This Year

Published on Wed Apr 07, 2010

Will the new Medicaid bounty hunters duplicate MIC scrutiny? If you submit claims to Medicaid, get ready for another set of eyes looking over your shoulder. The Patient Protection and Affordable Care Act (PPACA) calls for every state Medicaid program to contract with at least one Recovery Audit Contractor to review claims. That totals a minimum of 56 Medicaid RACs, points out consultant Tom Boyd with Rohnert Park, Calif.-based Boyd & Nicholas. Like their federal counterparts, Medicaid RACs would be paid on a contingency fee basis. That means their fee would be based on a percentage of the funds they recover. However, they also would receive a set fee for cases in which they find underpayments, adds the health care reform law that was enacted in March. Health care providers have roundly criticized this bounty hunter model of payment, which encourages RACs to make unnecessary recoupments, they say. The new [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Home Health & Hospice Week

View All